Policy Updates Medical Policy & Clinical GuidelinesCommercialNovember 30, 2020

Updates to AIM Cardiology Clinical Appropriateness Guidelines

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Effective for dates of service on and after March 14, 2021, the following updates will apply to the AIM Advanced Imaging of the Heart and Diagnostic Coronary Angiography Clinical Appropriateness Guidelines.

 

Evaluation of patients with cardiac arrhythmias

Updated repeat TTE criteria.

Added restrictions for patients whose initial echocardiogram shows no evidence of structural heart disease, and follow-up echocardiography is not appropriate for ongoing management of arrhythmia.

 

Evaluation of signs, symptoms, or abnormal testing

Added restrictions for TTE in evaluation of palpitation and lightheadedness based on literature.

 

Diagnostic Coronary Angiography

Updated criteria to evaluate patients with suspected congenital coronary artery anomalies.

As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:

  • Access AIM’s ProviderPortalSM directly at providerportal.com. Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Web Portal at availity.com
  • Call the AIM Contact Center toll-free number: 1-877-430-2288, Monday–Friday, 8:00 a.m.–6:00 p.m. ET.

 

For questions related to guidelines, please contact AIM via email at aim.guidelines@aimspecialtyhealth.com.  Additionally, you may access and download a copy of the current and upcoming guidelines here.

 

800-1220-PN-NY

 

PUBLICATIONS: December 2020 Empire Provider News